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  1. #21

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    What is your definition of a disease? The answer to the question hinges on that.

  2. #22

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    What diseases have no element of personal accountability?

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    Quote Originally Posted by manhn View Post
    What diseases have no element of personal accountability?
    Seriously?

    You can get an STD at birth if your mother had it and it wasn't treated.

    Cancers when you're of a young age. My friend died of pancreatic cancer at 31 and he had absolutely no risks. No family history, he wasn't overweight (quite the opposite), didn't have diabetes, didn't drink excessively, whatever. He didn't have any risks, and he developed it anyway.



    People can react to genetic predispositions in different ways. I have weak teeth. Instead of throwing up my hands and saying, "Well, there's nothing I can do about this so I might as well relegate myself to having a mouth full of crowns at 35," I bought a Sonicare. I floss. I cut up my apples and I'm very careful when biting into things. I've made a choice - I do not live like someone who has strong teeth and get away with things like chomping into an apple or breaking things open with my teeth.

    That's a really minor example, but I think acknowledging that something like addiction is partly out of your control can set realistic expectations for yourself. Realistic expectations means that you have a fighting chance of reaching those goals. Like, some recovering alcoholics can't say no to alcohol when it's in front of them. If they are aware of that, they can take that aspect out of the equation by turning down any social events where there will be alcohol. Yes, it's a choice, but it's also an acknowledgement that their addiction is out of their control in certain situations, so they're simply going to avoid those situations to get a handle on it.

    But YMMV with each person. As I said, brain chemistry is a finicky thing.

  4. #24
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    Quote Originally Posted by manhn View Post
    What diseases have no element of personal accountability?
    There are a pretty large number that are based on genetic mutations.
    What do people do to get Thalsemmia? (Probably spelled that wrong.) MS? ALS? CP?
    Are you accountable for being exposed to TB or meningitis? Leukemia isn't usually something you could prevent getting.

  5. #25

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    I think mahn may have meant what disease does not require you to manage it. Someone with juvenile diabetes didn't cause their disease but they are responsible for managing it - taking meds, etc. Pretty much any disease puts additional burdens of responsibility on the bearer. Not so much in the cause but in the response to the disease.
    What would Jenny do?

  6. #26
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    Quote Originally Posted by snoopy View Post
    I think mahn may have meant what disease does not require you to manage it. Someone with juvenile diabetes didn't cause their disease but they are responsible for managing it - taking meds, etc. Pretty much any disease puts additional burdens of responsibility on the bearer. Not so much in the cause but in the response to the disease.
    But, isn't that so with addiction? What do you imagine is the % of people who try pot, cocaine, alcohol, other drugs? The % is that 20% to 30% will become addicted. So, the person who is predisposed to addiction tries a drug, like anyone else and ….
    Last edited by cruisin; 02-07-2014 at 01:26 PM.

  7. #27
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    Quote Originally Posted by cruisin View Post
    But, isn't that so with addiction? What do you imagine is the % of people who try pot, cocaine, alcohol, other drugs? The % is that 20% to 30% will not become addicted. So, the person who is predisposed to addiction tries a drug, like anyone else and ….
    That brings up a "chicken or egg" question. I realized at a pretty young age that my family tree indicated that I was a genetic time bomb; a whole lot of addicts and other signs of serotonin imbalance in my relatives. So I decided to steer clear of addictive substances completely. (Not trivial when you attend some well-known "party schools". "What do you mean you don't drink?!?") Never triggered my genetic predisposition, never became addicted to anything. So....do I have a disease?

  8. #28
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    Quote Originally Posted by modern_muslimah View Post
    My mother works in the addiction treatment industry and they don't tell clients to just give up to a higher power. NA does this, I think, but modern treatment programs definitely hold clients accountable for their behavior. The organization she works for does view addiction as a disease but they also hold clients accountable if they relapse while in treatment. For instance, they may lose the privilege of going out during the weekend or worse, be kicked out. They have to explore what made them do drugs in the first, explore what triggers cause them to use, come up with plans to stay away from those triggers, learn to keep different company and stay away from areas that can trigger a craving, learn a job skill so they can be employable and hence have less time to get in trouble or hang with the wrong people, etc. So drug treatment programs definitely believe that clients do have some power over their addiction.
    That's good to hear.

  9. #29
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    Quote Originally Posted by susan6 View Post
    That brings up a "chicken or egg" question. I realized at a pretty young age that my family tree indicated that I was a genetic time bomb; a whole lot of addicts and other signs of serotonin imbalance in my relatives. So I decided to steer clear of addictive substances completely. (Not trivial when you attend some well-known "party schools". "What do you mean you don't drink?!?") Never triggered my genetic predisposition, never became addicted to anything. So....do I have a disease?
    I'd say that's a genetic predisposition that didn't progress to disease-state. You prevented yourself from getting addicted to anything, so you're not an addict.

    I have strong family history of osteoporosis, and I check off pretty much all the risk boxes. I'm taking calcium and I'm weightlifting to prevent it. I will not know until I am 50 if my efforts will be fruitful, but it's similar to your situation. I don't have osteoporosis, not technically. But I will if I don't do anything.

  10. #30
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    Susan6, I would agree with Anita. But some, who are genetically prone to addiction, are not as aware as you. Or they don't believe it will happen to them. Or, they could accidentally become addicted, via pain meds for an injury or surgery. I have an addictive personality, and have gone there with my eating disorder. I could, very easily have gotten hooked on Percodan, with the amounts I've been given for oral surgeries. But, I chose not to take them. So, while I have an addiction, I chose not to allow a substance addiction. Even though I am not active (in my ED), I still consider myself as having an ED.

    Anita, my family has a strong history of osteoporosis, as well. At this point, I have osteopina. I also take and eat calcium, walk 3 miles a day, and do weight lifting. That helps, but I did a lot of damage in all of those years of horrible eating/starving myself. And being 5' 10" and having very small bones doesn't help either.

  11. #31

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    Does it matter whether you call addiction a disease or not? Some people still have more predisposition to becoming addicted than others. There is a physical component, as we all react differently to different substances and stimuli, even within families. There is both a physical and environmental component to managing addiction. Sure personal responsibility plays a part, but some of us just have a tougher row to hoe than others. I don't see how changing labels will affect that.

  12. #32
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    Quote Originally Posted by aliceanne View Post
    Does it matter whether you call addiction a disease or not? Some people still have more predisposition to becoming addicted than others. There is a physical component, as we all react differently to different substances and stimuli, even within families. There is both a physical and environmental component to managing addiction. Sure personal responsibility plays a part, but some of us just have a tougher row to hoe than others. I don't see how changing labels will affect that.
    I believe that the importance is that, historically, mental illness (in general) was seen to be character flaw. That people who had psychological illnesses were weak or lazy, not ill. We have come to understand that there are physical and chemical reasons for people's behaviors and psych problems. If we recognize them as illness, the hope is that we can get the stigma psych illnesses to lessen. If people don't feel that they will be judged, they are more likely to get help. No one should ever be embarrassed to admit they have an illness, physical or mental.

  13. #33

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    Quote Originally Posted by aliceanne View Post
    Does it matter whether you call addiction a disease or not? Some people still have more predisposition to becoming addicted than others. There is a physical component, as we all react differently to different substances and stimuli, even within families. There is both a physical and environmental component to managing addiction. Sure personal responsibility plays a part, but some of us just have a tougher row to hoe than others. I don't see how changing labels will affect that.
    I think it matters. Both my parents to were alcoholics. Let me tell you... As the oldest of four kids in the 50's it was not a good time at my house. My dad died (ceirosis of the liver.. Shocker). That left us with mom. Not working. My aunts and uncles helped. But sometimes literally there was no food.... Always a bottle of Early Times though. And my mom was a rager. I was beaten soo badly I couldn't go to school. And the entire time I thought if she was good person she would stop. I am sure somewhere in her soul she thought that too. I was sure it was her fault for being weak. So the left me beaten and damaged and convinced my mother did not love me.... Cause if she loved me she would get a grip.

    Fast forward 40 years.. Lots of therapy and 5 kids later., no one was going to convince me it was a disease. Then my youngest became addicted to narcotics. Joy. Thought I had squeezed through rising these kids and avoided that. We had a family intervention. Not the kind where you capture the problem person and everyone else reads a letter. This was the kind that in am family with an addict everyone is a mess. We learned about brain chemistry and neurons and all that. And a great analogy. For an addict the disease is waiting there to be triggered. There is a line out there (different for all of us) and when the addict crosses the line and triggers the disease there is no going back. The person was a cucumber and then zappa they are a pickle, and you will never be a cucumber again.

    Like any disease you have to take responsibility and do the things you have to do to stay well. Think about the bi-polar person who doesn't want to take meds cause the highs are too fun. A million Al-Anon and AA meetings later I can say that turning it over to your higher power does not relieve you of responsibility. It means you recognize that there are things you cannot control.... Like people, places and things... And how Ashley skates tomorrow... So keep your attention on the things you can control... Like not drinking, not using and always trying to do the next right thing.

    I highly recommend Kristina Wandzilak and Constance Curry's THE LOST YEAR which chronicles Kristina's descent into drugs and alcohol, homelessness, prostitution and crime and her mother's journey from helpless enabler to strength and well being.
    DH - and that's just my opinion

  14. #34
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    (((AxelAnnie))) Reading your post mad me cry. It was heartbreaking to read about what you went through. And you spoke eloquently about addiction. Sending you a PM.

  15. #35
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    AxelAnnie, your family has been through so much. Your youngest is so, so blessed to have a family who supports them. Truly. My hat (and hugs) off to you.

  16. #36

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    Quote Originally Posted by sk8er1964 View Post
    The other thing that bothers me is that there are some people who get so addicted to their substance that they cannot quit, and others who can quit cold turkey and never look back. Why are these two types different? If it were a disease, wouldn't everyone who is addicted have the same trouble quitting?
    Some people do have more discipline or will-power than others. At the same time, one thing that a lot of people don't think about is the full extent of an individual's discipline or will-power, and the demands on it. If a person has to exercise discipline in their work and in raising their kids/managing their household, that person may have none left in reserve at the end of the day, whereas someone who is not working but has enough money to live on, and not stressed by raising kids or other things, may have more discipline left at the end of the day and a lot more time to think about healthy lifestyle habits.

    This is a generalization of course, but I am saying that stress is a factor in addictive behaviours - and lack of time. People use different things to cope with stress - not only alcohol and drugs, but also food, spending, gambling. Sugar is a big addiction in contemporary society and a lot of people depend on it to keep going. Work addiction is in fact encouraged and rewarded, and often accompanied by an inadequate amount of sleep. So bring on the caffeine and the sugar, and maybe a scotch on the rocks or two to unwind at the end of the day. And corporations are fueling the sugar addiction by putting it in pretty much all processed foods.

    So, addictions can be a coping mechanism and they can work very well as such. A lot of people are really just trying to get through the day.

    I used to cope with my work stress by chain smoking. Since I work at home on a computer, I could do that.

    I don't do that any more, but I can't work the way I used to anymore, either. In making the decision to stop smoking while working, I knew that I would need to sacrifice income. The smoking did serve a purpose. It did something to my brain that helped me to cope with the pressure of my work and to keep going past the point where I felt I needed to quit.

    The benefits gained by an addiction may therefore be one of the reasons why one person quits, and another person can't.


    Or is addiction more tied to mental illness, which can manifest in varying degrees in different people. I tend to think that is more correct. I often wonder if the addiction treatment industry is actually doing a disservice when they talk about giving up to a higher power and being powerless against their addiction. If my experience with nicotine (and caffeine, for that matter, which I also quit years ago) is any indication then I absolutely did have power over them.
    Addiction is definitely tied to mental illness. To give an example, paranoid schizophrenics smoke a lot more cigarettes and marijuana than the average person. It does something pleasant to their brains that helps them deal with their illness - that something involves endocannabinoids (I can't recite the actual neurological process involved without looking it up).

    The 'giving it up to a higher power and admitting one is powerless over ___ ' is the 12-step disease model. 'Higher power' is just a way to get people comfortable with the idea of 'God' IMO. The twelve-step model is ultimately a religious model as well as a disease model, and doesn't work work for everyone. AA is the original twelve step program and was oriented towards men who got drunk and then got into trouble (i.e bar brawls, domestic violence). Guys with big egos who believed that ego pummeling was necessary for their fellows to smarted up and 'get with the program'.

    I personally find the harm reduction model more positive and humane. And I don't care for the powerless approach, either. Many people are struggling with addictions precisely because they feel powerless over the stressors and difficult circumstances of their lives. And need to be empowered in order to deal better with the issues that drive them to engage in addictive behaviours.
    Last edited by Japanfan; 02-08-2014 at 07:56 AM.

  17. #37
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    Quote Originally Posted by PeterG View Post
    Right wing bullshit.

    Any responsible and professional treatment for addiction or any other kind of mental disorder emphasises taking responsibility.

    The underlying issue here is the black/white, essentialist, biological understanding of the word 'disease' blind to the cultural, social and psychological factors.

  18. #38
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    Quote Originally Posted by Japanfan View Post
    Some people do have more discipline or will-power than others. At the same time, one thing that a lot of people don't think about is the full extent of an individual's discipline or will-power, and the demands on it. If a person has to exercise discipline in their work and in raising their kids/managing their household, that person may have none left in reserve at the end of the day, whereas someone who is not working but has enough money to live on, and not stressed by raising kids or other things, may have more discipline left at the end of the day and a lot more time to think about healthy lifestyle habits.

    This is a generalization of course, but I am saying that stress is a factor in addictive behaviours - and lack of time. People use different things to cope with stress - not only alcohol and drugs, but also food, spending, gambling. Sugar is a big addiction in contemporary society and a lot of people depend on it to keep going. Work addiction is in fact encouraged and rewarded, and often accompanied by an inadequate amount of sleep. So bring on the caffeine and the sugar, and maybe a scotch on the rocks or two to unwind at the end of the day. And corporations are fueling the sugar addiction by putting it in pretty much all processed foods.

    So, addictions can be a coping mechanism and they can work very well as such. A lot of people are really just trying to get through the day.

    I used to cope with my work stress by chain smoking. Since I work at home on a computer, I could do that.

    I don't do that any more, but I can't work the way I used to anymore, either. In making the decision to stop smoking while working, I knew that I would need to sacrifice income. The smoking did serve a purpose. It did something to my brain that helped me to cope with the pressure of my work and to keep going past the point where I felt I needed to quit.

    The benefits gained by an addiction may therefore be one of the reasons why one person quits, and another person can't.
    Absolutely.

    I used to work in a cancer research lab. You would be SHOCKED by how many scientists in my department smoked. It was because of stress. Of course they know it's bad for them, but they can't give themselves the opportunity to stop.

    My old boss had a hilarious story where he went into another scientist's office for a chat. This particular scientist worked on research involving the carcinogenic effects of caffeine. And on his desk was a venti Starbucks. My boss sorta guffawed and the guy was like, "Yeah yeah, I know..."

  19. #39
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    Quote Originally Posted by Japanfan View Post
    The benefits gained by an addiction may therefore be one of the reasons why one person quits, and another person can't.
    And the perception society has of the nature of the addiction. Workaholics are praised. Positive reinforcement can make it harder to realize you have a problem. I think that is a part of the problem with EDs. There is so much positive reinforcement, at least initially. By the time the the person and people around them realize the healthy weightless has mutated to something far more serious, it is an addiction.


    The 'giving it up to a higher power and admitting one is powerless over ___ ' is the 12-step disease model. 'Higher power' is just a way to get people comfortable with the idea of 'God' IMO. The twelve-step model is ultimately a religious model as well as a disease model, and doesn't work work for everyone. AA is the original twelve step program and was oriented towards men who got drunk and then got into trouble (i.e bar brawls, domestic violence). Guys with big egos who believed that ego pummeling was necessary for their fellows to smarted up and 'get with the program'.

    I personally find the harm reduction model more positive and humane. And I don't care for the powerless approach, either. Many people are struggling with addictions precisely because they feel powerless over the stressors and difficult circumstances of their lives. And need to be empowered in order to deal better with the issues that drive them to engage in addictive behaviours.
    I agree that the 12 step program is not necessarily the best approach. Though, it does seem to work with many recovering addicts. I think it is the support system and the meetings, having a sponsor, that are most significant. Keep in mind, that the "Higher Power" is not necessarily God. It may have started out that way. But, now, "Higher Power" can be a power found in anything positive: yes, it can be God, or a friend, something inside yourself, a pastime/sport.

    Quote Originally Posted by Ziggy View Post
    Right wing bullshit.

    Any responsible and professional treatment for addiction or any other kind of mental disorder emphasises taking responsibility.

    The underlying issue here is the black/white, essentialist, biological understanding of the word 'disease' blind to the cultural, social and psychological factors.
    What does right wing anything have to do with this?

  20. #40
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    Quote Originally Posted by Japanfan View Post

    Addiction is definitely tied to mental illness. To give an example, paranoid schizophrenics smoke a lot more cigarettes and marijuana than the average person. It does something pleasant to their brains that helps them deal with their illness - that something involves endocannabinoids (I can't recite the actual neurological process involved without looking it up).
    Mood and appetite are both controlled by some of the same neurotransmitters (like serotonin). So people with mood disorders will also tend to have (or be related to people with) appetite disorders (ED, addictions). Wellbutrin is used to treat depression; the active ingredient is bupropion. The exact same chemical is in Zyban, which is used to aid in quitting smoking. A lot of antidepressants have as a side effect "may cause weight gain or weight loss"...the chemical which is addressing the mood disorder also changes appetite.

    So....if your family tree is filled with depressives and suicides and other mood disordered people.....you probably have a higher genetic predisposition for both depression and addiction. Tread carefully.
    Last edited by susan6; 02-08-2014 at 06:42 PM.

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